Types of brain tumours
Ependymoma is a rare type of brain tumour. It starts from ependymal cells in the brain or spinal cord. Ependymomas can develop in children and adults. This page is about ependymomas in adults.
Read about ependymomas in children
Symptoms of ependymomas depend on whether the tumour is in the brain or the spinal cord. Common symptoms include headaches and feeling or being sick.
Find out more about the symptoms of brain tumours
Ependymomas develop from ependymal cell. These cells line the fluid filled areas of the brain (ventricles) and the spinal cord.
In adults, most ependymomas start in the ependymal cells that line the spinal cord. They can spread into the fluid that surrounds the brain.
Doctors use a system to group (classify) brain tumours into different groups and types. The World Health Organisation (WHO) regularly update this system. The information on this page is based on the latest WHO classification of 2021.
There are different types of ependymoma. The doctors base the types on:
what the tumour cells looks like under the microscope
where the tumour is
changes (mutations) in genes in the tumour cells
There are 5 main types of ependymoma in adults. Some of these types are further divided into subtypes. This is based on changes to genes within the tumour. The 5 main types are:
posterior fossa ependymoma – these are in the lower back part of the brain (including the cerebellum and brain stem)
supratentorial ependymoma – these are in the upper part of the brain (including the cerebrum)
spinal cord ependymoma – these are in the spinal cord
subependymoma – these are slow growing tumours that can develop in any part of the brain or spinal cord
myxopapillary ependymoma – these are slow growing tumours that usually develop in the lower part of the spinal cord
Ependymomas are also put into groups according to how quickly they are likely to grow. This is called the grade. These tumours can be low grade (slow growing) or high grade (fast growing).
The grade depends on how the cells look. Generally, the more normal the cells look, the lower the grade. The more abnormal the cells look, the higher the grade. Grade also depends on genes and proteins in the tumour cells.
For most types of brain tumours, doctors can usually have an idea of how the tumour might behave by looking at the grade. But for ependymomas, the grade does not always fit with their behaviour. So the grade may not tell you much about how likely the tumour is to grow or spread.
For ependymomas:
most types are either grade 2 or grade 3
subependymomas are grade 1
Read more about the grades of brain tumours
Ependymomas are rare. About 1 out of every 100 brain tumours (about 1%) diagnosed in England between 1995 and 2017 were ependymomas.
Most ependymomas are high grade (fast growing).
You have tests to diagnose an ependymoma. Your doctor checks the size of the tumour and its location. This helps your doctor plan your treatment. The tests you might have include:
or
a test of your neurological system (neurological examination)
a
We have more information about the tests you might have to diagnose a brain tumour
Surgery is the main treatment for ependymomas. You may also have radiotherapy and chemotherapy.
The exact type of surgery you have depends on where the tumour is. A highly specialist doctor (neurosurgeon) removes as much of the tumour as possible.
We have more information about surgery for brain tumours
Radiotherapy uses high energy x-rays to destroy abnormal cells. You might have radiotherapy after surgery to reduce the risk of the tumour coming back.
You usually have radiotherapy to the whole brain and spinal cord if the ependymoma has spread to the fluid around the brain (cerebrospinal fluid). You might have radiotherapy to just the area of the tumour if there are no tumour cells found in the cerebrospinal fluid.
Find out about radiotherapy for brain tumours
Your specialist might recommend more radiotherapy or chemotherapy to shrink the tumour. Treatments can slow down the growth of the tumour and help you feel better.
You have regular appointments with your doctor or nurse after treatment finishes. Your doctor examines you at each appointment. They ask how you are feeling, whether you have had any symptoms or side effects, and if you are worried about anything. You might also have MRI scans on some visits.
How often you have checks ups depend on your individual situation.
You might have an MRI scan every 3 to 6 months, for two years. You then continue to have an MRI scan. How often depends on your situation. It might be every 6 months, every year or every 2 years.
Read more about follow up appointments after treatment for brain tumour
Coping with a diagnosis of a brain tumour can be difficult, both practically and emotionally. It can be especially difficult when you have a high grade tumour. Being well informed about the type of tumour you have, and its treatment can make it easier to cope.
Find out what you can do, who can help and how to cope with a brain tumour
Doctors are always trying to improve the diagnosis and treatment of brain tumours. As part of your treatment, your doctor might ask you to take part in a clinical trial. This might be to test a new treatment or look at different combinations of existing treatments.
Find out about the latest UK research and how you can take part in a clinical trial
Last reviewed: 08 Jun 2023
Next review due: 08 Jun 2026
Primary brain tumours are tumours that start in the brain. They can start anywhere in the brain and there are many different types of tumour.
Common symptoms of brain tumours include headaches, feeling or being sick and seizures (fits).
Treatment for a brain or spinal cord tumour depends on the type of tumour you have, where it is and your general health.
Practical and emotional support is available to help you cope with a brain or spinal cord tumour.
Survival depends on different factors such as the type, position and grade of your brain or spinal cord tumour.
Primary brain tumours are cancers that start in the brain.
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